BACKGROUND AND PURPOSE: HIV enters the CNS early in the course of infection and produces neuropsychiatric impairment throughout the course of illness, which preferentially affects the subcortical white matter. The development of a neuroimaging marker of HIV may allow for the earliest detection of cognitive impairment. The purpose of this study was to determine whether MR diffusion tensor imaging can detect white matter abnormalities in patients who have tested positive for HIV. METHODS: Ten patients with HIV (eight men and two women; mean age, 42 years) underwent MR imaging of the brain with MR diffusion tensor imaging, which included routine fluid-attenuated inversion recovery and fast spin-echo T2-weighted imaging. Diffusion constants and anisotropy indices were calculated from diffusion tensor maps. Peripheral viral load, Centers for Disease Control staging, and cluster of differentiation 4 levels were determined. RESULTS: All patients had normal results of MR imaging of the brain, except for mild atrophy. Four of 10 patients had undetectable viral loads. These patients were receiving highly active antiretroviral therapy. The diffusion constant and anisotropy were normal. Four of 10 patients had viral loads between 10,000 and 200,000. Diffusion anisotropy in the splenium and genu was significantly decreased (P < .02). The diffusion constant of the subcortical white matter was elevated in the frontal and parietooccipital lobes (11%). Two of 10 patients had viral loads >400,000. Anisotropy of the splenium was half normal (P < .0004) and of the genu was decreased 25% (P < .002). The average diffusion constant was diffusely elevated in the subcortical white matter. CONCLUSION: Calculating the diffusion constant and anisotropy in the subcortical white matter and corpus callosum in patients with HIV detected abnormalities despite normal-appearing white matter on MR images and nonfocal neurologic examinations. Patients with the highest diffusion constant elevations and largest anisotropy decreases had the most advanced HIV disease. Patients with the lowest viral load levels, who had normal anisotropy and diffusion constants, were receiving highly active antiretroviral therapy.
BACKGROUND AND PURPOSE:HIV enters the CNS early in the course of infection and produces neuropsychiatric impairment throughout the course of illness, which preferentially affects the subcortical white matter. The development of a neuroimaging marker of HIV may allow for the earliest detection of cognitive impairment. The purpose of this study was to determine whether MR diffusion tensor imaging can detect white matter abnormalities in patients who have tested positive for HIV. METHODS: Ten patients with HIV (eight men and two women; mean age, 42 years) underwent MR imaging of the brain with MR diffusion tensor imaging, which included routine fluid-attenuated inversion recovery and fast spin-echo T2-weighted imaging. Diffusion constants and anisotropy indices were calculated from diffusion tensor maps. Peripheral viral load, Centers for Disease Control staging, and cluster of differentiation 4 levels were determined. RESULTS: All patients had normal results of MR imaging of the brain, except for mild atrophy. Four of 10 patients had undetectable viral loads. These patients were receiving highly active antiretroviral therapy. The diffusion constant and anisotropy were normal. Four of 10 patients had viral loads between 10,000 and 200,000. Diffusion anisotropy in the splenium and genu was significantly decreased (P < .02). The diffusion constant of the subcortical white matter was elevated in the frontal and parietooccipital lobes (11%). Two of 10 patients had viral loads >400,000. Anisotropy of the splenium was half normal (P < .0004) and of the genu was decreased 25% (P < .002). The average diffusion constant was diffusely elevated in the subcortical white matter. CONCLUSION: Calculating the diffusion constant and anisotropy in the subcortical white matter and corpus callosum in patients with HIV detected abnormalities despite normal-appearing white matter on MR images and nonfocal neurologic examinations. Patients with the highest diffusion constant elevations and largest anisotropy decreases had the most advanced HIV disease. Patients with the lowest viral load levels, who had normal anisotropy and diffusion constants, were receiving highly active antiretroviral therapy.
Authors: J S Shimony; R C McKinstry; E Akbudak; J A Aronovitz; A Z Snyder; N F Lori; T S Cull; T E Conturo Journal: Radiology Date: 1999-09 Impact factor: 11.105
Authors: W G van Gorp; M A Mandelkern; M Gee; C H Hinkin; C E Stern; D K Paz; W Dixon; G Evans; F Flynn; C J Frederick Journal: J Neuropsychiatry Clin Neurosci Date: 1992 Impact factor: 2.198
Authors: R K Heaton; I Grant; N Butters; D A White; D Kirson; J H Atkinson; J A McCutchan; M J Taylor; M D Kelly; R J Ellis Journal: J Int Neuropsychol Soc Date: 1995-05 Impact factor: 2.892
Authors: R J Ellis; K Hsia; S A Spector; J A Nelson; R K Heaton; M R Wallace; I Abramson; J H Atkinson; I Grant; J A McCutchan Journal: Ann Neurol Date: 1997-11 Impact factor: 10.422
Authors: Marek Kubicki; Carl-Fredrik Westin; Stephan E Maier; Hatsuho Mamata; Melissa Frumin; Hal Ersner-Hershfield; Ron Kikinis; Ferenc A Jolesz; Robert McCarley; Martha E Shenton Journal: Harv Rev Psychiatry Date: 2002 Nov-Dec Impact factor: 3.732
Authors: Assawin Gongvatana; Ronald A Cohen; Stephen Correia; Kathryn N Devlin; Jadrian Miles; Hakmook Kang; Hernando Ombao; Bradford Navia; David H Laidlaw; Karen T Tashima Journal: J Neurovirol Date: 2011-10-01 Impact factor: 2.643
Authors: David F Tate; Jared Conley; Robert H Paul; Kathryn Coop; Song Zhang; Wenjin Zhou; David H Laidlaw; Lynn E Taylor; Timothy Flanigan; Bradford Navia; Ronald Cohen; Karen Tashima Journal: Brain Imaging Behav Date: 2010-01-19 Impact factor: 3.978
Authors: Eva M Müller-Oehring; Tilman Schulte; Margaret J Rosenbloom; Adolf Pfefferbaum; Edith V Sullivan Journal: Neuropsychologia Date: 2009-12-16 Impact factor: 3.139